Although depression guidelines discourage monotherapy with benzodiazepines, patients with depression continue to receive benzodiazepine monotherapy. This study evaluates the prevalence and predictors of benzodiazepine in depressed patients.
Benzodiazepines are used widely for anxiety and insomnia, but what proportion of users are misusing them? This analysis of National Surveys on Drug Use and Health data considers correlates of different levels of benzodiazepine use and the motivations for misuse, with the goal of identifying those who may be at risk.
Many patients with panic disorder have short-term response to psychotherapy, but subsequent relapse can occur. Read this article to learn if treatment gains achieved with 3 different psychotherapies were maintained after 6 months and 1 year.
Do depressed patients with comorbid panic disorder have antidepressant treatment side effect profiles that differ from those of patients without panic disorder? Check out this article to review the effects that panic disorder might have on antidepressant treatment course.
Benzodiazepine and Z-drug dependence are frequently comorbid with other substance use and psychiatric disorders. Read this brief report to gain a greater understanding of the clinical characteristics and course of substance dependence in this group of patients.
Treating panic disorder usually involves cognitive-behavioral therapy or pharmacotherapy. However, randomized controlled trials indicate that psychodynamic psychotherapies also have efficacy for some anxiety disorders. This study by Milrod et al compared findings from 2 sites at which panic-focused psychodynamic psychotherapy was compared with cognitive-behavioral therapy and applied relaxation training.
The antidepressant efficacy of ketamine is clear, but what about its use in other psychiatric disorders? Read about a case of sustained symptom relief following a single ketamine infusion in a patient with treatment-refractory panic disorder, agoraphobia, and generalized anxiety disorder.
Do you prescribe benzodiazepines to your patients with schizophrenia? Learn more about the risk-benefit profile of this strategy by reading this journal CME study. The findings on mortality risk may surprise you.
Baclofen, a French Exception, Seriously Harms Alcohol Use Disorder Patients Without Benefit
To the Editor: Dr Andrade’s analysis of the Bacloville trial in a recent Clinical and Practical Psychopharmacology column, in which he concluded that “individualized treatment with high-dose baclofen (30-300 mg/d) may be a useful second-line approach in heavy drinkers” and that “baclofen may be particularly useful in patients with liver disease,” deserves comment.1
First, Andrade failed to recall that the first pivotal trial of baclofen, ALPADIR (NCT01738282; 320 patients, as with Bacloville), was negative (see Braillon et al2).
Second, Dr Andrade should have warned readers that Bacloville’s results are most questionable, lacking robustness. Although he cited us,3 he overlooked the evidence we provided indicating that the Bacloville article4 was published without acknowledging major changes to the initial protocol, affecting the primary outcome. Coincidentally (although as skeptics, we do not believe in coincidence), the initial statistical team was changed when data were sold to the French pharmaceutical company applying for the marketing authorization in France. As Ronald H. Coase warned, “If you torture the data long enough, it will confess.”